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Saturday, October 3, 2009

Looking to History for Mothers in Medicine

Here are few remarks excerpted from a talk I gave about a travelling National Library of Medicine exhibit on women in medicine that is currently at my school and may come to others. The exhibit is very worth a visit, even from an overbusy motherdoc. The students in the audience seemed to share my thoughts--many are struggling with the same concerns we have all had about integrating our many roles:

"I graduated from medical school in 1977. A picture of my class could have found a place on one of the panels of a history of medicine exhibit, as it was, I believe, the very first class at my medical school to have more than a token number of women—30% rather than 10% or fewer. What that meant to me concretely was that my male classmates could look around at their peers and professors themselves for models, inspiration on how to build a life and a career in medicine. In school, I could look to my peers for ideas on how to remove the smell of formaldehyde from my hands. Later they showed me how a woman can be an effective teacher or begin a research career, but for inspiration, I had to look backwards in time to the women sporadically flung up by the tides of history. Reading about the checkered history of strange and sometimes misguided study and treatment of disease by strange and sometimes misguided practitioners helped me form a realistic view of medicine, to lose the naïve assumption that one had to be a genius to enter this profession and that once in, one could never make a mistake.

Elizabeth Blackwell, of course, was the subject of various biographies for children that I read in elementary school and every other book about women in medicine that I read after that. I admired her determination and commitment, but I was always troubled by her detour away from what was called allopathic medicine into homeopathy, as well as by her unmarried and apparently unmarriageable state. In my college, which had originally been an all women’s school, I stumbled across Dr. Edward H. Clarke's publication Sex in Education; or, A Fair Chance for the Girls (1873). Clarke was a professor at the Harvard Medical School, and seems to have been panicked at the sight of blood. Aside from unbending prejudice, that was the only way I understand his argument that women were so weakened by the menstrual blood loss that they could not possibly tolerate the rigors of secondary education, much less enter any of the professions. He suggested all women should lie in a quiet room for a week every month, to conserve their strength to bear healthy children. Clarke’s contemporary on the faculty, Oliver Wendell Holmes Sr, clearly knew this was nonsense, but all he ever did to counter it was to state in his eulogy for Clarke that he knew Clarke sincerely believed in his own thesis. I was thrilled when I learned that Mary Putnam, another early woman physician, had demolished Clarke’s work by rigorous research conducted during her post graduate training in Paris. Her complete and influential refutation of Clarke in fact laid the groundwork for the creation of elite women’s colleges around the country, and accounts for the emphasis they placed on athletics as well as scholarship.

Still looking for models for myself, I was also very relieved to read that Putnam not only succeeded in influencing the whole of her profession, she also married and was the mother of two children. Still seeking a guide on my own path into medicine, I found her story a bit intimidating, given that I could not imagine having her commitment to science, or her critical intelligence. She saw clearly the inadequacies of her own training in the US, and went off to remedy that in nearly complete isolation from friends and family, not to mention other women physicians.

Regina Markel Morantz’ article comparing Elizabeth Blackwell and Mary Putnam Jacobi clarified a lot for me. These two women represented different poles of feminism—ones still relevant in my era in college in the 1970s and even today. Blackwell was a “difference” feminist who believed that women’s unique nature would lead them to be more understanding, more gentle and feminine in their professional practice. Ironically, since Blackwell herself was never a wife or mother, it was Putnam (Jacobi) who was what has been termed an “equity” feminist. Despite (or perhaps because) of her personal adoption of the conventional roles of wife and mother, she successfully argued and demonstrated that women deserved the same opportunities to achieve as men, given their equal abilities. I could only sit on the sidelines of history chanting the “right on!”, the 70s equivalent of “You go, girl!’, though I did become convinced that I could handle being in medicine, and would not have to abandon my hopes for a family as well."

I wonder if other bloggers find history as important as I do as a way of understanding the way our current context influences how we feel about ourselves and our choices?

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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